Active NPI
Emma Grace Wagstaff, RD
- Registered Dietitian
- Sandy, UT
National Provider Identifier
1710670914
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86294476
- Practice address
- 45 W 9000 S Ste 1
Sandy, UT 84070-2047 - Phone
- (801) 558-8281
- NPI assigned
- Jun 1, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 86294476 | UT | Primary |
Addresses
Primary practice location
45 W 9000 S Ste 1
Sandy, UT 84070-2047
Mailing address
3781 S Forest Hills Dr
Salt Lake City, UT 84106-4208
Phone (801) 558-8281
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 86294476 | UT | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1685577600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1685577600000",
"number": "1710670914",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3781 S FOREST HILLS DR",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841064208",
"telephone_number": "801-558-8281"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "45 W 9000 S STE 1",
"city": "SANDY",
"state": "UT",
"postal_code": "840702047",
"telephone_number": "801-558-8281"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGSTAFF",
"first_name": "EMMA",
"middle_name": "GRACE",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-06-01",
"last_updated": "2023-06-01",
"certification_date": "2023-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "UT",
"license": "86294476",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sandy, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.